Krukenberg tumor

クルケンベルグ腫瘍

WordNet

1. an abnormal new mass of tissue that serves no purpose (同)tumour, neoplasm

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/24 21:22:24」(JST)

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Krukenberg tumor
Krukenberg Tumor
Classification and external resources
ICD-10	C56
ICD-9	183
ICD-O	8490/6
DiseasesDB	30081
MeSH	D007725

A Krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast. Gastric adenocarcinoma, especially at the pylorus, is the most common source. Krukenberg tumors are often (over 80%) found in both ovaries, consistent with its metastatic nature.

Historical

Krukenberg tumors are named after Friedrich Ernst Krukenberg (1871–1946), who reported what he thought was a new type of primary ovarian malignancy in 1896; six years later these were shown to be of metastatic gastrointestinal tract origin. However, Paget had described the process in 1854.

Etiology and incidence

Krukenberg tumors can be seen in all age groups, with an average age of 45 years. In most countries, cancer that has metastasized to the ovary accounts for only about 1 to 2% of ovarian cancer; in the remainder, the ovary itself is the primary cancer site. However, in Japan they represent a much higher percentage of malignancies in the ovary (almost 20%) due to the increased prevalence of gastric cancer.

Krukenberg tumors account for about 15% of metastatic cancers that initially appear to have arisen in the ovary, and as such is less common than metastasis arising from ovarian epithelial and germ-cell tumors.

In people who have had nongynecologic malignancy, approximately 20% of adnexal masses are malignant, and 60% of these are Krukenberg tumors.

Symptoms

Krukenberg tumors often come to the attention when they cause abdominal or pelvic pain, bloating, ascites, or pain during sexual intercourse. Krukenberg tumors can occasionally provoke a reaction of the ovarian stroma which leads to hormone production, that results in vaginal bleeding, a change in menstrual habits, or hirsutism, or occasionally virilization as a main symptom.

All these symptoms are non-specific and can also arise with a range of problems other than cancer, and a diagnosis can only be made following confirmatory investigations such as computed tomography (CT) scans, laparotomy and/or a biopsy of the ovary.

Pathogenesis

There has been debate over the exact mechanism of metastasis of the tumor cells from the stomach, appendix or colon to the ovaries. Classically it was thought that direct seeding across the abdominal cavity accounted for the spread of this tumor, but spread by way of the lymphatic is considered more likely. The average age of diagnosis of Krukenberg tumors may partly relate to the relatively increased vascularity of the ovaries.

Microscopically, Krukenberg tumors are often characterized by mucin-secreting signet-ring cells in the tissue of the ovary; when the primary tumor is discovered, the same signet-ring cells are typically found. However, other microscopic features can predominate. Krukenberg tumors are most commonly metastases from gastric cancer, particularly adenocarcinoma, or breast cancer particularly invasive lobular breast carcinoma, but they can arise in the appendix, colon, small intestine, rectum, gallbladder, and urinary bladder or gallbladder, biliary tract, pancreas, ampulla of Vater or uterine cervix.

Immunohistochemistry may help in diagnosing Krukenberg tumors from primary ovarian neoplasms but needs to be applied with discretion. For example, tumors that are immunoreactive to CEA or cytokeratin 20 (CK20) and negative for cytokeratin 7 (CK7) may be more likely to be of colorectal origin.

Treatment and prognosis

Since Krukenberg tumors are secondary (metastatic), management might logically be driven by identifying and treating the primary cancer. The optimal treatment of Krukenberg tumors is unclear. The role of surgical resection has not been adequately addressed but if metastasis is limited to the ovaries, surgery may improve survival. The role of chemotherapy and/or radiotherapy is uncertain but may be sometimes be beneficial.

References

External links

• 00498 at CHORUS

UpToDate Contents

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• 1. 上皮性卵巣癌、卵管癌、および腹膜癌：臨床的特徴および診断 epithelial carcinoma of the ovary fallopian tube and peritoneum clinical features and diagnosis
• 2. 虫垂癌および腹膜偽粘液腫 cancer of the appendix and pseudomyxoma peritonei
• 3. 妊娠時のアンドロゲン過剰症の原因 causes of gestational hyperandrogenism

English Journal

• Dyspnoea and the ovaries: a rare presentation of Krukenberg tumour.

• Rawasia WF, Chaddha U, El-Kersh K, Perez RL.SourceDepartment of Medicine, University of Louisville, Kentucky, USA.
• BMJ case reports.BMJ Case Rep.2013 Feb 1;2013. pii: bcr2012008302. doi: 10.1136/bcr-2012-008302.
• Krukenberg tumour is a metastatic signet-ring adenocarcinoma of the ovary, usually with a gastrointestinal primary detected metachronously or synchronously. We present here a case of a 48 year-old woman who presented with a prolonged history of dyspnoea on exertion. Workup had revealed a pelvic mass
• PMID 23378553

• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves the survival of gastric cancer patients with ovarian metastasis and peritoneal dissemination.

• Wu XJ, Yuan P, Li ZY, Bu ZD, Zhang LH, Wu AW, Zong XL, Li SX, Shan F, Ji X, Ren H, Ji JF.SourceDepartment of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital, Beijing Cancer Hospital & Institute, 52 Fu-Cheng Road, Hai-Dian District, 100142, Beijing, China.
• Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine.Tumour Biol.2013 Feb;34(1):463-9. doi: 10.1007/s13277-012-0571-4. Epub 2012 Oct 30.
• The prognosis for ovarian metastasis of gastric cancer is poor. There is no currently available treatment for this disease. The purpose of this study was to evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) in female gastric cance
• PMID 23108893

• Unilateral ovarian metastasis from gastric mucinous adenocarcinoma visualized on FDG PET/CT.

• Tamam MO, Mulazimoglu M, Kamali G, Eker O, Ozpacaci T.SourceDepartment of Nuclear Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey. mugetamam@yahoo.com
• European review for medical and pharmacological sciences.Eur Rev Med Pharmacol Sci.2012 Oct;16 Suppl 4:1-3.
• BACKGROUND: Krukenberg tumor is a metastatic ovarian tumor with primary focus usually seen in the gastrointestinal tract. Metastatic involvement of the ovary is an uncommon manifestation of malignancy. We report a [18F]-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography (FDG P
• PMID 23090794

Japanese Journal

• 脱毛,卵巣腫瘤,腹壁皮膚転移から胃癌の診断に至った1例

• 鈴木 亜紀子,佐藤 友隆,岸野 竜平 [他]
• 医療 65(6), 337-340, 2011-06
• NAID 40019028018

• 長期生存が得られたKrukenberg腫瘍合併Meckel憩室癌の1例

• 石上 俊一,矢澤 武史,大江 秀明,北口 和彦,浦 克明,平良 薫,吉川 明,田村 淳,馬場 信雄,白瀬 智之
• 日本消化器外科学会雑誌 43(6), 654-660, 2010-06-01
• 患者は69歳の女性で,2004年11月の卵巣腫瘍摘出術の際に,回腸末端から約70cmの腸間膜対側に充実性腫瘍を伴う径2cmのMeckel憩室を指摘された.右卵巣腫瘍,憩室腫瘍とも中分化型腺癌であり,いずれも免疫組織学的検査でサイトケラチン(以下,CK)7(-),CK20(+)であることから,Meckel憩室癌の卵巣転移と診断された.ムチンコア蛋白(以下,MUC)の免疫組織染色でMUC1(+),MU …
• NAID 110007656698

Related Links

• Krukenberg tumor - Wikipedia, the free encyclopedia

A Krukenberg tumor refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast. Gastric adenocarcinoma, especially at the pylorus, is the ...

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「クルケンベルグ腫瘍」

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英

Krukenberg's tumor, Krukenberg tumor

同

Krukenberg腫瘍、クルーケンベルク腫瘍

関

胃癌、卵巣癌

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「tumor」

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• n.

• 腫瘍、腫瘤、腫脹